ADVANCED NURSING PHARMACOLOGY PASS PACK |MCQ PRACTICE QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
A patient with heart failure is prescribed digoxin. The nurse notes the patient's serum potassium level is 3.1
mEq/L. Which action should the nurse take first?
A. Administer the digoxin as prescribed
B. Notify the healthcare provider of the potassium level
C. Administer potassium supplements as prescribed
D. Hold the digoxin and notify the healthcare provider
🟢 Correct Answer:
D. Hold the digoxin and notify the healthcare provider
🔴 RATIONALE:
Hypokalemia (serum potassium < 3.5 mEq/L) significantly increases the risk of digoxin toxicity. The nurse should
hold the digoxin and notify the healthcare provider immediately. Administering the digoxin could precipitate
life-threatening arrhythmias. Potassium supplementation may be ordered but should not be administered
without a provider's order.
Question 2
A patient is receiving a continuous infusion of heparin for a deep vein thrombosis. The nurse notes that the
,patient's aPTT is 95 seconds (therapeutic range 60-80 seconds). What is the nurse's priority action?
A. Continue the infusion at the current rate
B. Decrease the heparin infusion rate
C. Increase the heparin infusion rate
D. Administer protamine sulfate
🟢 Correct Answer:
B. Decrease the heparin infusion rate
🔴 RATIONALE:
An aPTT of 95 seconds is above the therapeutic range, indicating the patient is at increased risk for bleeding.
The nurse should decrease the infusion rate per protocol and notify the healthcare provider. Protamine sulfate
is the antidote for heparin and is used for significant bleeding, not for an elevated aPTT without bleeding.
Question 3
A patient with type 2 diabetes is prescribed metformin. The nurse should monitor for which serious adverse
effect?
A. Lactic acidosis
B. Hypoglycemia
C. Weight gain
D. Peripheral edema
🟢 Correct Answer:
A. Lactic acidosis
,🔴 RATIONALE:
Metformin can cause lactic acidosis, a rare but serious adverse effect, especially in patients with renal
impairment, hepatic disease, or heart failure. The nurse should monitor for signs such as muscle pain, weakness,
and hyperventilation. Hypoglycemia is uncommon with metformin alone.
Question 4
A patient is prescribed warfarin (Coumadin) for atrial fibrillation. The nurse notes the patient's INR is 1.8. What is
the nurse's priority action?
A. Administer the next dose of warfarin as scheduled
B. Hold the next dose and notify the healthcare provider
C. Administer vitamin K intravenously
D. Increase the dose of warfarin per protocol
🟢 Correct Answer:
A. Administer the next dose of warfarin as scheduled
🔴 RATIONALE:
A therapeutic INR for atrial fibrillation is typically 2.0-3.0. An INR of 1.8 is subtherapeutic, indicating the patient
is at increased risk for thromboembolic events. The nurse should administer the next dose as prescribed and
anticipate a dose adjustment by the provider. Holding the dose would further increase the risk.
, Question 5
A patient with asthma is prescribed an inhaled corticosteroid. Which instruction should the nurse include in the
teaching?
A. "Rinse your mouth with water after each use."
B. "Use this medication for acute shortness of breath."
C. "Take this medication with a full glass of water."
D. "Avoid using a spacer with this medication."
🟢 Correct Answer:
A. "Rinse your mouth with water after each use."
🔴 RATIONALE:
Inhaled corticosteroids can cause oral thrush. Rinsing the mouth with water after each use helps prevent this
complication. They are maintenance medications and should not be used for acute symptom relief. A spacer is
often recommended to improve delivery.
Question 6
A patient is prescribed an ACE inhibitor. The nurse should monitor for which adverse effect?
A. Dry cough and hyperkalemia
B. Tachycardia and hyperglycemia
C. Hypotension and hypokalemia
D. Weight gain and edema
GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
A patient with heart failure is prescribed digoxin. The nurse notes the patient's serum potassium level is 3.1
mEq/L. Which action should the nurse take first?
A. Administer the digoxin as prescribed
B. Notify the healthcare provider of the potassium level
C. Administer potassium supplements as prescribed
D. Hold the digoxin and notify the healthcare provider
🟢 Correct Answer:
D. Hold the digoxin and notify the healthcare provider
🔴 RATIONALE:
Hypokalemia (serum potassium < 3.5 mEq/L) significantly increases the risk of digoxin toxicity. The nurse should
hold the digoxin and notify the healthcare provider immediately. Administering the digoxin could precipitate
life-threatening arrhythmias. Potassium supplementation may be ordered but should not be administered
without a provider's order.
Question 2
A patient is receiving a continuous infusion of heparin for a deep vein thrombosis. The nurse notes that the
,patient's aPTT is 95 seconds (therapeutic range 60-80 seconds). What is the nurse's priority action?
A. Continue the infusion at the current rate
B. Decrease the heparin infusion rate
C. Increase the heparin infusion rate
D. Administer protamine sulfate
🟢 Correct Answer:
B. Decrease the heparin infusion rate
🔴 RATIONALE:
An aPTT of 95 seconds is above the therapeutic range, indicating the patient is at increased risk for bleeding.
The nurse should decrease the infusion rate per protocol and notify the healthcare provider. Protamine sulfate
is the antidote for heparin and is used for significant bleeding, not for an elevated aPTT without bleeding.
Question 3
A patient with type 2 diabetes is prescribed metformin. The nurse should monitor for which serious adverse
effect?
A. Lactic acidosis
B. Hypoglycemia
C. Weight gain
D. Peripheral edema
🟢 Correct Answer:
A. Lactic acidosis
,🔴 RATIONALE:
Metformin can cause lactic acidosis, a rare but serious adverse effect, especially in patients with renal
impairment, hepatic disease, or heart failure. The nurse should monitor for signs such as muscle pain, weakness,
and hyperventilation. Hypoglycemia is uncommon with metformin alone.
Question 4
A patient is prescribed warfarin (Coumadin) for atrial fibrillation. The nurse notes the patient's INR is 1.8. What is
the nurse's priority action?
A. Administer the next dose of warfarin as scheduled
B. Hold the next dose and notify the healthcare provider
C. Administer vitamin K intravenously
D. Increase the dose of warfarin per protocol
🟢 Correct Answer:
A. Administer the next dose of warfarin as scheduled
🔴 RATIONALE:
A therapeutic INR for atrial fibrillation is typically 2.0-3.0. An INR of 1.8 is subtherapeutic, indicating the patient
is at increased risk for thromboembolic events. The nurse should administer the next dose as prescribed and
anticipate a dose adjustment by the provider. Holding the dose would further increase the risk.
, Question 5
A patient with asthma is prescribed an inhaled corticosteroid. Which instruction should the nurse include in the
teaching?
A. "Rinse your mouth with water after each use."
B. "Use this medication for acute shortness of breath."
C. "Take this medication with a full glass of water."
D. "Avoid using a spacer with this medication."
🟢 Correct Answer:
A. "Rinse your mouth with water after each use."
🔴 RATIONALE:
Inhaled corticosteroids can cause oral thrush. Rinsing the mouth with water after each use helps prevent this
complication. They are maintenance medications and should not be used for acute symptom relief. A spacer is
often recommended to improve delivery.
Question 6
A patient is prescribed an ACE inhibitor. The nurse should monitor for which adverse effect?
A. Dry cough and hyperkalemia
B. Tachycardia and hyperglycemia
C. Hypotension and hypokalemia
D. Weight gain and edema
